Monday, April 20, 2009

I need to rant a little bit.

O.K., so I had a bit of a bad day at work.  It wasn't anything hugely atrocious, just a bunch of little things.  I started off my day without caffeine, which wasn't good.  But I got a cup of Earl Grey in me and felt much better.  My group was heavy today, high acuity.  I had two patients who had tracheostomies and PEG tubes and required total care, frequent suctioning, etc.  My other two patients consisted of another total-care patient with slightly lower acuity, and a young lady with a husband who's being investigated for domestic violence who was at the bedside all day (so there was an extreme family dynamic there).  Three of my four patients had multiple lines, needed meds to be crushed, were in restraints, etc.  I had PEG care to do, trach care, two IV's went bad, and another patient ran a temperature and needed pan-culturing (blood, sputum, and urine), which required suctioning a trach, straight-cathing the patient, and two difficult sticks for the blood cultures.  That's just a taste of how my morning went.  So, by the afternoon, everyone was well cared-for, but my charting was backed up.  Just as I sit down to gather myself and start charting, my supervisor comes to me and tells me I'm getting an admission on the Stroke hall.  That's around the corner and on the opposite side of the Neurosurgery unit that I was on!  What's more, the patient had already had three witnessed seizures that day, so he needed to be watched carefully.  My problem wasn't so much that I had a heavy group already, or that I was getting an admission on top of it.  It was that it was UNSAFE to have a patient who needed close monitoring so far away from the rest of my patients.  I had to leave my restrained, trached, needing-to-be-suctioned patients to watch over my seizure patient, or leave my seizure patient to tend to my others.  I spoke with my manager about this.  She values my opinion, even though I've only been there for a short time.  I know I'm young, but I've been around the country in about a dozen different hospitals.  I've seen things run well, and I've seen things run terribly.  I've seen what works and what doesn't.  Anyway, when I was talking to my boss, I mentioned that, when I was charge nurse, I took a patient or two (or even three!) if we were getting slammed with admissions or if my nurses were sinking.  And that was only two years out of school!  I'm grateful to Cheryl, the nurse who mentored me in those early years and taught me not only good nursing practice, but leadership as well.  Back to my boss was surprised when I said that.  Then another nurse chimed in and mentioned that his charge did the same thing where he came from.  It's not a big deal to take a patient.  One patient is easy, and it boosts the morale of your nurses and helps them get their work done safely.  I wrapped up my night at 8:30 pm, an hour after my shift ended.  I had to stay and finish the charting on which I was so behind.  All of my patients were fine, and my admit didn't have any more seizures, so it's all good.  I hope things change soon.  The sad thing is that it's only that one charge nurse who does that.  The others at least TRY to keep your patients close together, at least on the same UNIT.  *sigh*  Well, there are new positions coming up, a super-resource nurse of sorts, three per shift with 17 patients and their nurses under their wing.  This nurse is to help in any way she can, and would all but eliminate problems like what I had today.  My boss has already approached me for one of the positions.  It's a lateral "promotion", but it would allow me to become a certified Neuro nurse and exercise my leadership roles without actually being charge nurse.  Geez...I usually try to keep work out of my blog, but I just needed to get this out of my system.  I feel better.  And tired.

On the lighter side of life, I'm working on a baby blanket for Leslie, a girl at work who will be having a little girl soon!  It's a super soft and squooshy pink-and-purple boucle yarn.  If I have enough yarn leftover, I'll knit a little matching hat.  I'm still working on Scott and Donna's blanket as well.  I want to make some appliqued burp cloths for Leslie's babe as well, if I have the time.  This Mama Makes Stuff has a great tutorial on how to dye and make them.  Also, I want to try my hand at converting vintage t-shirts into baby sleepers, also a tutorial from This Mama Makes Stuff.  Or was it Little Birdie Secrets?  I don't remember...I look at both of their blogs so often, sometimes their contents and ideas blur together in my brain.

Once we figure out how to upload pics from our camera to the Mac (I think we just have to use a USB cable rather than inserting our memory card), I have some pics to post on here.  But for now I'm going to do some work on Trav's blog, then shower and sit in the recliner with a cup of Sleepytime laced with honey and a hot pack to my aching shoulder.  Hmmmmm...that sounds so  good!

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